Carrington-Hsia-Nieves Doctoral Scholarship for Midwives of Color

The A.C.N.M. Foundation, Inc. 8403 Colesville Road, Suite 1550 Silver Spring, Maryland 20910-6374

2021 Carrington-Hsia-Nieves Doctoral Scholarship for Midwives of Color

PURPOSE:

The Carrington-Hsia-Nieves Doctoral Scholarship for Midwives of Color is awarded to a CNM/CM of color who is actively enrolled in doctoral or post-doctoral education. This award is named in honor of three of our most distinguished midwives of color: Betty Watts Carrington, CNM, PhD, FACNM; Lily Hsia, CNM, PNP, MSN, FACNM; and the late Nivia Nieves Fisch, CNM, FACNM and is supported by the A.C.N.M. Foundation's Midwives of Color Scholarship Fund.

AWARD AMOUNT: $5,000.00

APPLICATION DEADLINE: September 12, 2021

ELIGIBILITY REQUIREMENTS:

? Be a certified nurse-midwife (CNM) or a certified midwife (CM). ? Be a current member of the American College of Nurse-Midwives (ACNM). ? Be actively enrolled in a doctoral or post-doctoral education program and be a student in good standing. ? Self-identify as a person of color.

COMPLETE APPLICATIONS MUST INCLUDE THE FOLLOWING:

? Part 1: Applicant Information ? Part 2: Professional and Academic Background, including CV and Sample Scholarly Work ? Part 3: Academic/Practice Career Plans ? Part 4: Intended use of Funds/Budget Outline ? Part 5: Future Contributions to ACNM & Midwifery ? Part 6: Academic Program Verification - to be submitted by your program director at:

o ? Part 7: Academic Recommendations from two (2) individuals, with the preference that at least one is a CNM

or CM, to be submitted at: o

Completed applications must be submitted no later than September 12, 2021, by email or mail to:

The A.C.N.M. Foundation, Inc. PO Box 380272 Cambridge, MA 02238-0272

Email: foundation@ Telephone: (240) 485-1850

Page 1 of 8

The A.C.N.M. Foundation, Inc. 8403 Colesville Road, Suite 1550 Silver Spring, Maryland 20910-6374

2021 Carrington-Hsia-Nieves Doctoral Scholarship for Midwives of Color

PART 1: Applicant Information PART 1a: Applicant Name, Contact, and ACNM Information

Name:

Academic/Clinical Credentials:

Ethnicity/Race

Asian

Black

Hispanic/LatinX

Yes Street:

Current Address: City:

Phone:

Cell:

Emails:

Work/School:

ACNM Membership #:

Indigenous

White

No

Other

State: Zip code: Home:

Country:

Personal: Year Certified by ACNM/AMCB:

Page 2 of 8

The A.C.N.M. Foundation, Inc. 8403 Colesville Road, Suite 1550 Silver Spring, Maryland 20910-6374

2021 Carrington-Hsia-Nieves Doctoral Scholarship for Midwives of Color

PART 1b: Graduate Program Information

Name of Program: Academic Institution:

Street:

Address:

City:

Degree:

Degree Being Sought:

State: Zip code:

Country:

Expected Graduation Date:

Graduate Program Description (brief):

Dissertation/Thesis Topic:

Page 3 of 8

The A.C.N.M. Foundation, Inc. 8403 Colesville Road, Suite 1550 Silver Spring, Maryland 20910-6374

2021 Carrington-Hsia-Nieves Doctoral Scholarship for Midwives of Color

PART 1c: Applicant Statement:

If awarded an A.C.N.M. Foundation, Inc. Carrington-Hsia-Nieves Doctoral Scholarship, I agree to:

? Submit periodic progress reports on a regular basis as outlined in an award letter ? Acknowledge The A.C.N.M. Foundation, Inc. in any professional activities, including presentations and

publications, which directly result from the award.

Applicant signature:

Date:

~ Go to Next Page ~

Page 4 of 8

The A.C.N.M. Foundation, Inc. 8403 Colesville Road, Suite 1550 Silver Spring, Maryland 20910-6374

2021 Carrington-Hsia-Nieves Doctoral Scholarship for Midwives of Color

ACNM Membership #:

Degree:

Degree Being Sought:

Year Certified by ACNM/AMCB: Expected Graduation Date:

Graduate Program Description (brief):

Dissertation/Thesis Topic:

Page 5 of 8

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download